West Carter County Ambulance

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

035009 Issued in MO

Legal business name

WEST CARTER COUNTY AMBULANCE

Practice address

1301 Main St.
Van Buren, MO 63965-0160

Phone

(573) 323-4791

Fax

(573) 323-8030

NPI assigned

Mar 22, 2007

Last updated

Mar 5, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael C Kennedy, EMT-P

Title

EMS Manager

Phone

(573) 323-4791

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520208000000",
    "number": "1962528760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "VAN BUREN",
            "state": "MO",
            "postal_code": "639650160",
            "telephone_number": "573-323-4791",
            "fax_number": "573-323-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MAIN ST.",
            "city": "VAN BUREN",
            "state": "MO",
            "postal_code": "639650160",
            "telephone_number": "573-323-4791",
            "fax_number": "573-323-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CARTER COUNTY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2018-03-05",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EMS MANAGER",
        "authorized_official_telephone_number": "573-323-4791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-P"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "035009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800551509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Van Buren R-1 School
• Shiloh Renee Vantassel
• Ryan Clarke Vanwinkle, LPC
• Karla Dawn Weatherford
• Paige Nichole Weaver
• Linda Kaye White, LPN
• Tori Marie Willis

• Land Ambulance in Van Buren, MO
• Providers in Van Buren, MO by specialty
• Land Ambulance in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.